Physician Advisor: Utilization & Care Quality Lead

Highmark Health; Pittsburgh (Allegheny County); On-site; USD 200,000 - 250,000; Full time

Job summary

Highmark Health is seeking a full-time Physician Advisor in Pittsburgh, PA. This role involves ensuring effective use of healthcare services by collaborating with a multidisciplinary team and conducting utilization management reviews. Candidates must possess significant clinical practice experience, relevant medical degrees, and be licensed in Pennsylvania. The position offers the opportunity to engage in hospital quality improvement initiatives and manage cross-functional interactions within the healthcare team. Competitive benefits and a commitment to diversity are provided.

Qualifications

• 5 years of clinical practice experience in a hospital setting required.
• Must be licensed in the state of Pennsylvania prior to employment.

Responsibilities

• Ensure cost-effective use of healthcare services for patients.
• Collaborate with interdisciplinary care team.
• Perform level of care reviews and handle peer-to-peer discussions with payers.

Skills

Clinical practice experience

Medical expertise

Collaboration

Analytical skills

Education

Doctor of Medicine (MD) or Doctor of Osteopathy (DO)

Board Certified in any Medical Subspecialty

Licensed in Pennsylvania

Job description

Highmark Health is seeking a full-time Physician Advisor in Pittsburgh, PA. This role involves ensuring effective use of healthcare services by collaborating with a multidisciplinary team and conducting utilization management reviews. Candidates must possess significant clinical practice experience, relevant medical degrees, and be licensed in Pennsylvania. The position offers the opportunity to engage in hospital quality improvement initiatives and manage cross-functional interactions within the healthcare team. Competitive benefits and a commitment to diversity are provided.